北京市城乡限定人群白内障手术负荷量及术后视力评价

目的：探讨北京限定区域城市及农村人群白内障患病率、低视力及手术负荷量，分析白内障手术覆盖率及术后视力情况。方法：晶状体图像资料完整的40岁以上受试者4364人(农村1909人，城市2455人)，所有受试者均进行问卷调查及眼部检查。眼部检查包括裸眼及矫正视力、电脑验光、眼压、散瞳后裂隙灯检查，数码照相采集晶状体图象及眼底照相。白内障手术负荷量入选标准：(1)符合白内障诊断；(2)除外角膜病、青光眼、眼底病、严重沙眼性角膜混浊等影响视力的疾病；(3)标准一：单眼矫正视力≤0.3；标准二：双眼矫正视力≤0.3。结果：本次调查白内障患病率为16.3％，其中双眼矫正视力≤0.3者14例，手术负荷量为0.32％(农村0.52％，城市0.16％)；单眼矫正视力≤0.3者67例，手术负荷量为1.54％(农村1.89％，城市1.26％)。对白内障手术需求女性大于男性，随年龄增加，需求上升，农村高龄女性需求最大。已行白内障手术者共55例(72只眼)，总的白内障手术覆盖率为7.03％，其中农村为4.71％，城市为9.03％，女性6.69％，男性为7.33％，农村女性的手术覆盖率最低，为3.77％。白内障手术后矫正视力≤0.3者占18.06％。术后视力不佳的原因为后发性白内障、眼底病变及其它手术并发症等。结论：白内障手术需求农村高于城市，农村高龄女性需求最大；白内障手术后总体视力提高欠佳；白内障手术需求远远超过现有的手术能力。     

山东省农村50岁及以上人群白内障患病率及手术状况的调查分析

目的 调查山东省农村50岁及以上人群白内障患病率、白内障手术覆盖率、白内障盲人社会负担率。 设计 以人群为基础的横断面调查。研究对象  2008年4-7月在山东省不同经济发展水平的县（市）、区中选择4个县（市）、区（乳山市、滕州市、鄄城县、济南市槐荫区）作为调查地。抽取50岁及以上受检者17816例。方法 对所有受检者进行视力和眼部检查,包括评价晶状体混浊程度和白内障手术状况。主要指标 白内障患病率、人工晶状体（IOL）植入率、白内障手术覆盖率、白内障盲人社会负担率。结果  在17816名受检者中,发现白内障4938例,患病率为27.72%。高龄、女性、文盲人群的白内障患病率较高,差异有统计学意义（P＜0.01）。在受检的4938例白内障患者中,249例310眼接受了白内障手术,接受白内障手术的率为1.40%;其中194眼（62.58%）采用现代囊外摘除联合IOL植入术,32眼（10.32%）采用超声乳化吸除联合IOL植入术;239眼植入了IOL,IOL植入率为77.10%。白内障手术覆盖率为36.77%,白内障盲人社会负担率为2.12%。随着年龄增长和文化程度降低,白内障盲人社会负担率逐渐增高,这种变化趋势有统计学意义（P＜0.05）。结论  山东省农村50岁及以上人群的白内障患病率较高、白内障手术覆盖率仍较低,手术治疗白内障盲依然是防盲工作的重点。（眼科,2013,22： 234-239）     

The epidemiology of cataract in Australia

PURPOSE: To describe the prevalence and risk factors for cataract in an Australian population aged 40 years and older. METHODS: Participants were recruited by a household census and stratified, random cluster sampling to represent residents of Victoria, Australia, aged 40 years and older. The following information was collected: initial visual acuity and best-corrected visual acuity, demographic details, health history, dietary intake of antioxidants, lifetime ocular ultraviolet B exposure, and clinical eye examination, including lens photography. Cortical opacities were measured in sixteenths. Cortical cataract was defined as opacity greater than or equal to 4/16 of pupil circumference. Nuclear opacities were graded according to the Wilmer cataract grading scheme, and cataract was defined as greater than or equal to nuclear standard 2.0 of four standards. The height and width of any posterior subcapsular opacity was measured and recorded. Posterior subcapsular cataract was defined as posterior subcapsular opacity greater than or equal to 1 mm2. The worse eye was selected for analysis. Backward stepwise logistic regression was used to quantify independent risk factors for cataract. RESULTS: A total of 3,271 (83% of eligible) of the urban residents, 403 (90% of eligible) nursing home residents, and 1,473 (92% of eligible) rural residents participated. The urban residents ranged in age from 40 to 98 years (mean, 59 years), and 1,511 (46%) were men. The nursing home residents ranged in age from 46 to 101 years (mean, 82 years), and 85 (21%) were men. The rural residents ranged in age from 40 to 103 years (mean, 60 years), and 701 (47.5%) were men. The overall weighted rate of cortical cataract was 11.3% (95% confidence limits, 9.68%, 13.0%) excluding cataract surgery and 12.1% (95% confidence limits, 10.5%, 13.8%) including cataract surgery. The risk factors for cortical cataract that remained in the multivariate logistic regression model were age, female gender, diabetes duration greater than 5 years, gout duration greater than 10 years, arthritis diagnosis, myopia, use of oral beta-blockers, and increased average annual ocular ultraviolet B exposure. Overall, 12.6% (95% confidence limits, 9.61%, 15.7%) of Victorians aged 40 years and older had nuclear cataract including previous cataract surgery, and 11.6% (95% confidence limits, 8.61%, 14.7%) had nuclear cataract excluding previous cataract surgery. In the urban and rural cohorts, age, female gender, rural residence, brown irides, diabetes diagnosed 5 or more years earlier, myopia, age-related maculopathy, having smoked for greater than 30 years, and an interaction between ocular ultraviolet B exposure and vitamin E were all risk factors for nuclear cataract. The rate of posterior subcapsular cataract excluding previous cataract surgery was 4.08% (95% confidence limits, 3.01%, 5.14%), whereas the overall rate of posterior subcapsular cataract including previous cataract surgery was 4.93% (95% confidence limits, 3.68%, 6.17%) . The independent risk factors for posterior subcapsular cataract in the urban and rural cohorts that remained were age in years, rural location, use of thiazide diuretics, vitamin E intake, and myopia. CONCLUSIONS: The expected increase in the prevalence of cataract with the aging of the population highlights the need to plan appropriate medical services and public health interventions for primary and secondary prevention. Many of the identified risk factors for cataract in the population have the potential for being modified through public health interventions.     

Cataract blindness and visual outcome of cataract surgery in a tribal area in Pakistan

AIM: To estimate the rates of cataract blindness and cataract surgical coverage and to assess the visual outcome of cataract surgery among individuals aged > or =50 years in Orakzai Agency, Pakistan. METHODS: 1600 individuals aged > or =50 years were selected using probability proportional to size sampling. The main outcome measure was bilateral cataract blindness which was defined as visual acuity of <3/60 in the better eye with best available correction and with obvious central lens opacities/absence of red reflex in both eyes. RESULTS: A total of 1549 people were examined; the coverage rate was 96.8%. Of individuals who were examined, 958 (61.8%) were men. The overall prevalence of bilateral cataract blindness was 4.8% (95% CI: 3.8% to 5.9%). Women had a 2.1-fold greater prevalence of bilateral cataract blindness than men (7.1% (5.0% to 9.2%) v 3.4% (2.3% to 4.6%); p = <0.0001). However, cataract surgical coverage rates were lower for women than men. The overall quality of previous cataract surgery was poor: 43.1% eyes with cataract surgery had VA <6/60. 73.3% people with bilateral cataract blindness reported they could not undergo cataract surgery because they were too poor to afford its cost. CONCLUSION: The unacceptably high rates of cataract blindness and poor affordability and visual outcome of cataract surgery calls for the establishment, in the agency, of static cataract surgical services that are high quality, affordable, and gender sensitive.     

Cataract blindness and barriers to uptake of cataract surgery in a rural community of northern Nigeria

AIMS: A population based cross sectional survey was conducted to determine the magnitude of cataract blindness and the barriers to uptake of cataract services in a rural community of northern Nigeria. METHODS: 1461 people out of 1924 registered eligible people were examined. The study population was chosen by two stage cluster random sampling. In the first sampling stage 15 villages were randomly chosen while in the final stage 170 people who were 40 years and over were selected in each village. Each selected person had visual acuity recorded for both eyes. Those with vision of less than 3/60 in the better eye were assessed for cataract. People with cataract were asked why they had not sought medical attention. RESULTS: A blindness prevalence of 8.2% (95% CI 5.8%-10.5%) was found among the sampled population. Cataract was responsible for 44.2% of the blindness. Thus, a cataract blindness prevalence of 3.6% was found. The cataract surgical coverage (people) was 4.0% and the couching coverage (people) was 18%. The main barrier to seeking cataract surgery was cost of the service (61%). CONCLUSION: Some regions of the world still have high burden of cataract blindness that needs attention. Such areas need an effective free cataract outreach programme.     

无锡市50岁及以上人群白内障患病率和手术情况调查

背景 白内障是主要的致盲眼病,中国白内障患者逐年增加,由此带来的社会问题日益严重.目的 调查无锡市50岁及以上人群白内障患病率、白内障患者手术覆盖率及白内障患者的社会负担率.方法 采用整群随机抽样的方法.收集2010年1-12月无锡市滨湖区28个调查点50岁及以上人群共6722名居民,进行详细的病史采集和眼部检查,统计该人群中白内障的患病率及手术覆盖率,评估白内障患者的视功能.本研究遵循医学伦理学准则,经江苏省卫生厅批准,受检者在检查前均签署知情同意书.结果 受检者共6 150例,应答率91.5％.受检者中诊断为白内障者1 564例,白内障的患病率为25.43％.高龄、女性、文盲、有高血压病、糖尿病病史、吸烟史、饮酒史的人群白内障患病率明显增高,差异均有统计学意义（x2=927.835、18.508、303.968、11.934、17.956、32.091、35.290,P＜0.01）.以双眼最佳矫正视力＜0.05作为盲的标准,已行手术的白内障盲者与未手术的白内障盲者的总优势比值为3.15（85/27）,白内障盲者总手术覆盖率为75.89％（85/112）,白内障盲者社会总负担率为1.82％（112/6 150）.随着年龄的增长和受教育程度的降低,白内障盲的手术覆盖率逐渐降低,这种趋势差异无统计学意义（P＞0.05）,而白内障盲者的社会负担率逐渐增加的趋势差异有统计学意义（P＜0.01）.结论 高龄、女性和文盲的白内障是无锡地区比较严重的问题,白内障盲者的社会负担率仍然比较高,白内障仍然是防盲、治盲的工作重点.     

西藏林周縣盲患病率及白内障手術狀况調查

目的調查西藏拉薩市林周縣40歲及以上人群中盲患率和白内障盲人手術覆蓋率及盲人社會負擔率.方法2000年4月采用整群隨機抽樣方法對林周縣44個自然村3071例40歲及以上人群進行視力和眼部檢查.結果檢錄40以上共3346.受檢率爲91.8%(3071/3346).以雙眼日常生活視力<0.1爲標準,盲患病率3.3%(101/3071).白内障是致盲的主要原因,有64.4%(65/101)的雙眼盲人致少有1眼是白内障.白内障手術率覆蓋率爲63.0%(85/135).白内障盲人的社會負擔率爲4.4%.結論高原地區盲患病率較高,白内障是致盲的主要原因,白内障所造成的社會負擔較重.     

Prevalence and associations of cataract in a rural Chinese adult population: the Handan Eye Study

Background

Cataract remains the leading cause of blindness and visual impairment in the world and in China. However, data on the prevalence of cataract based on standardized lens grading protocols from mainland China are limited. This paper estimated the age- and gender-specific prevalence and risk factor for cataract

Methods

In a population-based Chinese sample, participants underwent a comprehensive ophthalmic examination, including assessment of cortical, nuclear, posterior subcapsular (PSC) and mixed lens opacities from slit-lamp grading using the Lens Opacities Classification System III.

Results

Of the 7,557 eligible subjects, 6,830 took part in the study (90.4?% response rate), and 6,544 participants (95.8?%, mean age 52.0?±?11.8 years) had lens data for analyses. The prevalence of any cataract surgery in at least one eye was 0.8?% (95?% confidence interval [CI], 0.62, 1.06), with similar rates between men and women. The overall prevalence of any cataract or cataract surgery was 20.8?% (95?% CI, 19.8, 21.8), higher in women than in men after adjusting for age (23.6?% vs 17.6?%; OR: 1.78; 95?% CI: 1.54–2.07). When distinct lens opacity was categorized in each eye as cortical, nuclear, PSC or mixed, based on one randomly selected eye, cortical cataract was the most common distinct subtype (12.3?%), followed by mixed (3.2?%), nuclear (1.7?%), and PSC (0.2?%) cataract. The prevalence of all lens opacities increased with age (P?<?0.001). After excluding other causes for visual impairment, the proportion of people with best corrected visual acuity <20/60 was 21?% among those with PSC, and 12?% among those with mixed opacities in the better-seeing eye. In multivariable logistic regression models, myopia was associated with all cataract types, while higher fasting plasma glucose and diabetes were only associated with PSC cataract.

Conclusions

Cataract affects 20?% of the population aged 30 years and older living in rural China, with cortical cataract the most common subtype. Risk factors for cataract include myopia and diabetes.     

Attributable risk estimates for cataract to prioritize medical and public health action

PURPOSE: Cataract is the most common cause of blindness in the world. The purpose of this study was to estimate the population attributable risk associated with identified risk factors for cortical, nuclear, and posterior subcapsular (PSC) cataract in a representative sample of the Victorian population aged 40 years and older. METHODS: Cluster, stratified sampling was used and participants were recruited through a household census. At locally established test sites, standardized clinical examinations were performed to assess cataract and personal interviews were conducted to quantify potential risk factors. Multivariate logistic regression was used to determine the independent risk factors associated with the three types of cataract, and the population attributable risk was calculated. RESULTS: A total of 3271 (83% of eligible) of the urban residents and 1473 (92%) rural residents participated. The urban residents ranged in age from 40 to 98 years (mean, 59 years), and 1511 (46%) were men. The rural residents ranged in age from 40 to 103 years (mean, 60 years), and 701 (48%) were men. The overall prevalence of cortical cataract was 12.1% (95% CL 10.5, 13.8), nuclear cataract 12.6% (95% CL 9.61, 15.7), and PSC cataract 4.93% (95% CL 3.68, 6.17). Significant risk factors for cortical cataract included age, female gender, diabetes for greater than 5 years, gout for greater than 20 years, arthritis, myopia, average annual ocular UV-B exposure, and family history of cataract (parents or siblings). Significant risk factors for nuclear cataract included age, female gender, rural residence, age-related maculopathy, diabetes for greater than 5 years, smoker for greater than 30 years, and myopia. The significant risk factors for PSC cataract were age, rural residence, thiazide diuretic use, and myopia. Of the modifiable risk factors, ocular UV-B exposure explains 10% of the cortical cataract in the community, and cigarette smoking accounts for 17% of the nuclear cataract. CONCLUSIONS: Because of the near universal exposure to UV-B in the environment, ocular protection has one of the highest modifiable attributable risks for cortical cataract and would therefore be an ideal target for public health intervention. Quit smoking campaigns can be expanded to incorporate information about the excess cataract in the community associated with long-term smoking. Nonmodifiable risk factors such as age, gender, and long-term medication use have implications for the timely referral and treatment for those at higher risk of cataract.     

佛山地区50岁及以上人群白内障患病情况的流行病学调查

目的：调查佛山50岁及以上人群的白内障患病情况。方法：对目标人群进行整群抽样。2014－01／2015－06对4539名调查对象进行视力、眼压、验光、裂隙灯、眼底照相等检查。结果：在4539名受检者中,发现白内障患者641例,患病率14．12％。白内障患病率随年龄的增加而上升（ P＜0．05）,城乡之间的白内障患病率差异显著（P＜0．05）,但性别差异不明显（ P＞0．05）。结论：白内障是佛山城乡地区50岁及以上人群的主要致盲性眼病。     

Operated and unoperated cataract in Australia

Purpose : To quantify the prevalence of cataract, the outcomes of cataract surgery and the factors related to unoperated cataract in Australia. Methods : Participants were recruited from the Visual Impairment Project: a cluster, stratified sample of more than 5000 Victorians aged 40 years and over. At examination sites interviews, clinical examinations and lens photography were performed. Cataract was defined in participants who had: had previous cataract surgery, cortical cataract greater than 4/16, nuclear greater than Wilmer standard 2, or posterior subcapsular greater than 1 mm ² . Results : The participant group comprised 3271 Melbourne residents, 403 Melbourne nursing home residents and 1473 rural residents. The weighted rate of any cataract in Victoria was 21.5%. The overall weighted rate of prior cataract surgery was 3.79%. Two hundred and forty‐nine eyes had had prior cataract surgery. Of these 249 procedures, 49 (20%) were aphakic, 6 (2.4%) had anterior chamber intraocular lenses and 194 (78%) had posterior chamber intraocular lenses. Two hundred and eleven of these operated eyes (85%) had best‐corrected visual acuity of 6/12 or better, the legal requirement for a driver’s license. Twenty‐seven (11%) had visual acuity of less than 6/18 (moderate vision impairment). Complications of cataract surgery caused reduced vision in four of the 27 eyes (15%), or 1.9% of operated eyes. Three of these four eyes had undergone intracapsular cataract extraction and the fourth eye had an opaque posterior capsule. No one had bilateral vision impairment as a result of cataract surgery. Surprisingly, no particular demographic factors (such as age, gender, rural residence, occupation, employment status, health insurance status, ethnicity) were related to the presence of unoperated cataract. Conclusions : Although the overall prevalence of cataract is quite high, no particular subgroup is systematically under‐serviced in terms of cataract surgery. Overall, the results of cataract surgery are very good, with the majority of eyes achieving driving vision following cataract extraction.     

Rapid assessment of visual impairment due to cataract and cataract surgical services in urban Argentina

AIM: To present results of a rapid assessment on visual impairment due to cataract and on cataract surgical services in the Northwestern districts of Buenos Aires, Argentina. These results will enable health managers to plan effective interventions in this area in line with VISION 2020. METHODS: One hundred fifteen clusters of 40 persons of 50 years and older in each cluster (4600 eligible persons) were selected by systematic sampling from the Northwestern districts of Buenos Aires, Argentina. This area consists of 10 districts with a total population of 2,716,573 (2001 census), from whom 4302 persons were examined (coverage 93.5%). The visual acuity was measured with a tumbling E-chart and the lens status with distant direct ophthalmoscopy. RESULTS: Cataract is the major cause of bilateral blindness (54.2%). The age and sex adjusted prevalence of bilateral cataract blindness (presenting VA < 20/400) in people of 50 years and older was 0.5% (95% CI: 0.4-0.8%), an estimated number of 2,985 persons. The cataract surgical coverage at this level was 70% for males and 78% for females. The prevalence of bilateral cataract and VA < 20/200 in persons of 50 years and older was 0.8% (95% CI: 0.6-1.1), an estimated 4,705 persons. In this last group, the surgical coverage was 66% (persons) and 57% (eyes). Of all operated eyes, 10% could not see 20/200. 'Cannot afford' (32%), 'unaware of cataract' (21%) and 'contraindication for surgery' (18%) were mentioned most as reason why surgery had not been done. CONCLUSION: The cataract problem is getting under control in this area. Coverage indicators are fairly high, and the outcome data better than in other studies. The cataract surgical rate could be raised further by awareness campaigns and by making cataract surgery more affordable.     

北京市顺义区白内障患病和手术状况的调查

目的　调查北京市顺义区50岁及以上人群中白内障患病率、白内障盲人手术覆盖率和白内障盲人社会负担率,以此了解白内障的患病状况及评价10余年来该区实施以白内障手术治疗为主的防盲治盲工作的效果。方法　1996年9月,采用整群随机抽样方法对顺义区抽取28个调查点5084例50岁及以上人群进行视力和眼部检查,包括应用裂隙灯检查受检者晶状体;了解接受白内障手术的情况。结果　5084例受检者中,白内障患病率为23.31%。随着年龄的增加,白内障患病率明显增高。在女性和文盲者中的白内障患病率较高,分别为26.01%及37.33%;1984年后,白内障手术率持续增加,以双眼小孔视力＜0.05作为盲的标准,白内障手术覆盖率为56.36%,白内障盲人的社会负担率为1.63%。以双眼日常生活视力<0.1为标准,白内障手术的覆盖率为47.79%,白内障盲人的社会负担率为2.22%。在70岁以上人群、女性和文盲者中,白内障手术覆盖率较低,分别为36.36%、44.87%及44.09%。白内障盲人的社会负担率较高,分别为6.84%、2.74%及3.90%。结论白内障仍是高龄者的致盲眼病,白内障盲人所造成的社会负担较重。在老龄、女性及文盲中因白内障引起的盲目仍是顺义区目前存在的严重问题。     

Preoperative visual acuity of people undergoing cataract surgery in rural and urban Nepal

Background: Preoperative presenting visual acuity (PPVA) is not a commonly reported indicator for the delivery of cataract services. This study aimed to evaluate the PPVA of patients undergoing cataract surgery in rural and urban areas of Nepal. Design: A prospective, non‐interventional study conducted from October 2007 to March 2008 in a tertiary hospital and outreach clinics of Nepal. Participants: A total of 3023 consecutive subjects from urban and rural settings (1323 from the tertiary hospital and1700 from outreach clinics) with cataract were included. Methods: Visual acuity was tested with a Snellen E‐chart at 6 m by ophthalmic assistants. All Outreach Microsurgical Eye Clinic patients were examined by either ophthalmologists or senior ophthalmic assistants. Patients at the Tertiary Eye Care Centre were examined only by ophthalmologists. Main Outcome Measures: Preoperative presenting visual acuity of patients undergoing cataract surgery was measured in both the settings. Results: The sex ratio was 0.96 (male/female). Based on PPVA, 11.5% of patients operated were blind (PPVA < 3/60 in the better eye). The proportion of blind people operated was similar in rural (11.4%) to urban (11.6%) areas. The proportion of blind eyes operated was higher in rural (50.7%) compared to urban (38.9%) areas. Conclusion: Despite a comparatively high volume of cataract surgery carried out in Nepal every year, only about one in eight patients operated for cataract in the sample population was blind. PPVA is an important indicator for the progress towards eliminating cataract blindness.     

A survey of blindness and cataract surgery in Doumen County, China.

PURPOSE: To assess blindness prevalence and that caused specifically by cataract in rural southern China. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 5342 persons older than 50 years of age. METHODS: Visual acuity and eye examinations were performed in the summer of 1997 in a random sample of villages in Doumen County. Differences in blindness prevalence associated with age, gender, and education were explored using logistic regression. The survey was preceded by a pilot study in which operational methods were refined and quality assurance measures were performed. MAIN OUTCOME MEASURES: Distance visual acuity and lens status. RESULTS: Bilateral blindness (presenting visual acuity < 0.10) was found in 4.37% (95% confidence interval, 3.67%-5.06%). Blindness was associated with increasing age (P < 0.001) and with the lack of education (P < 0.01). Cataract was the principal cause of blindness in at least one eye in 61.5% of blind people, with refractive error responsible for another 10%. An estimated 40% of the cataract blind were operated on; surgical coverage was lowest among the elderly, women, and those without schooling, although not at statistically significant levels. CONCLUSIONS: Despite the increased attention given to eye care in Doumen County, blindness remains a major public health problem. Cataract surgery is reaching fewer than half of those who could benefit from it.     

Cataract in central Sri Lanka: cataract surgical coverage and self-reported barriers to cataract surgery

Purpose:  To determine the cataract surgical coverage and investigate the barriers to cataract surgery in the Kandy District of central Sri Lanka.
Methods:  A population-based, cross-sectional ophthalmic survey of the inhabitants of rural villages in central Sri Lanka was conducted; there were 1721 eligible subjects and 1375 participated (79.9% participation rate). The recorded data included age, gender, education, district, corrected visual acuity, dilated slit-lamp examination and stereoscopic fundus examination. Lens opacity was graded using the Lens Opacities Classification System III. Participants with cataract-induced visual impairment (acuity <6/18 in the better eye) were also invited to respond to a verbal questionnaire about barriers to cataract surgery.
Results:  Cataract surgical coverage per individual for visual acuity cut-offs of <6/18, <6/60 and <3/60 was 41.9%, 76.8% and 82.7%, respectively; and per eye was 34.0%, 60.3% and 65.2%, respectively. Cataract surgical coverage was higher for men than women, and two-thirds refused referral for surgery, for the following reasons: no desire to improve vision, fear of surgery and lack of awareness were the most frequently reported barriers.
Summary:  Cataract surgical coverage in central Sri Lanka is higher than that in neighbouring developing regions. Surgical uptake may be improved through better community education.     

中国白内障人群术前结膜囊细菌培养结果的Meta分析

目的：系统研究中国白内障人群术前结膜囊细菌构成和药物敏感情况的变化,为白内障术前无菌化准备提供科学的理论依据。

方法：计算机检索中文科技期刊数据库、万方数据库、中国知网学术文献网络出版总库及中文生物医学文献数据库。收集2004-01/2013-09发表的有关中国人群白内障结膜囊细菌培养的文献,并辅以手工检索、因特网搜索。并采用Meta分析对所纳入研究结果进行分析。

结果：共纳入7篇文献,共11499眼,白内障患者术前结膜囊培养阳性率为26.03%(2993/11499),主要由G⁺球菌(86.40%)、G⁺杆菌(8.10%)、G^-杆菌(4.13%)以及G^-球菌(1.37%)构成。G⁺球菌主要以表皮葡萄球菌(67.30%)、金黄色葡萄球菌(12.53%)和微球菌(6.98%)为主。大多菌株对妥布霉素、万古霉素、环丙沙星和庆大霉素敏感,对妥布霉素和环丙沙星耐药性有上升趋势。

结论：白内障术前的结膜囊主要由表皮葡萄球菌构成,对青霉素和红霉素耐药,大多数菌株对妥布霉素、万古霉素、环丙沙星和庆大霉素敏感,对妥布霉素和环丙沙星耐药性有上升趋势。     

Prevalence of blindness and cataract surgery in Nepal

BACKGROUND—A national eye care programme was launched in Nepal in the early 1980s. The impact of this programme on blindness and cataract surgery prevalence was evaluated in two geographic zones.
METHODS—People aged 45 years and older were sampled using a stratified cluster design. Within randomly selected clusters, door to door enumeration was followed by visual acuity measurement and eye examinations at conveniently located sites. The full survey was preceded by a pilot study where operational methods were refined and quality assurance measures carried out.
RESULTS—Of the 5112 enumerated individuals 90% were examined. Blindness, defined as presenting visual acuity less than 6/60 in both eyes, was found in 5.3% (95% CI 3.6, 6.8) of individuals examined, with cataract being the principal cause in at least one eye in 78% of cases. Considering both cataract operated and unoperated cataract blind cases, surgical coverage was approximately 42%.
CONCLUSION—The findings suggest that blindness prevalence may have decreased slightly from that estimated in a 1981 national survey, both overall and cataract related. Similarly, cataract surgical coverage may have increased somewhat. None of these changes, however, are at statistically significant levels. Accordingly, the blindness problem remains challengingly high.

Keywords: blindness prevalence, cataract blindness, aphakia/pseudophakia     

北京市和宁城县非眼科住院患者及家属的青光眼与白内障意识调查

目的调查及比较北京市和宁城县人群中的青光眼和白内障的意识水平,以探索有效的眼病宣教方式。设计横断面调查。研究对象北京同仁医院和内蒙古宁城县医院的206名非眼科住院患者及家属。方法问卷调查。听说过青光眼或白内障病名者定义为有青光眼或白内障意识,至少能说出一个青光眼或白内障症状者定义为有青光眼或白内障知识。分析比较两种疾病间、城乡间眼病意识的差异,Logistic回归分析相关因素。主要指标有青光眼或白内障意识、知识的率。结果有青光眼意识者占全部的74．76％,在北京及宁城分别占90．38％、58．82％（P=0．000）。有白内障意识者占全部的92．94％,在北京及宁城分别占97．12％、86．36％（P=0．008）。有青光眼知识者占有青光眼意识者的48．7％,占全部的36．41％。有白内障知识者占有白内障意识者的59．50％,占全部的55．29％。青光眼、白内障之间及城乡之间均有显著性差异。Logistic回归分析显示,文化程度与青光眼或白内障的意识程度有关。最主要信息来源是听周围人谈论及通过电视节目。50．97％的人会主动学习青光眼或白内障相关知识,主要通过书籍（66％）及与医护人员交流（43％）。仅15．53％的人表示将参加医院举办的知识讲座。结论我国人群中青光眼意识和知识水平还比较低,对白内障的意识和知识水平好于青光眼;且城乡之间存在差别,这与文化程度差异有关。需要更有效的健康教育方式来提高青光眼或白内障的意识和知识水平。     

我国白内障的流行病学调查资料分析

目的 探讨我国白内障的患病率与各地检查条件、诊断标准及地理环境的关系。方法 采用世界卫生组织盲与低视力标准,对全国抽样调查资料进行统计学分析。结果 双眼视力〈０．３的白内障患者约５００万人,患病率为０．４６％;盲与低视力的患病率分别为０．４３％和０．５８％。盲人中白内障致盲占４１．０６％;低视力患者中４９．３８％为白内障所致;白内障致老年盲（年龄≥６０岁）及低视力占７３．１３％。以晶体混及视力〈０